Alcohol and cannabis use are prevalent among young adults in Canada. Additionally, heavier substance use is associated with an increased likelihood of experiencing negative consequences resulting from use. Given the potential for harmful consequences resulting from alcohol and cannabis use, it is important to understand why people use these substances. Childhood maltreatment has been identified as an important predictor of alcohol and cannabis use. However, less is known about the mechanisms underlying this relationship, though it seems emotion regulation may play an important role. This study explores the relationship between maltreatment and emotion dysregulation, in addition to the relationship between maltreatment and affective motives for using alcohol and marijuana. Results indicate that drinking to cope mediates the relationship between all measured forms of maltreatment and alcohol consequences. However, none of the motives individually significantly mediated the relationship between maltreatment and marijuana use consequences. Results, limitations, and future directions are discussed.

Alcohol and cannabis use are prevalent among young adults in Canada. Additionally, heavier substance use is associated with an increased likelihood of experiencing negative consequences resulting from use. Given the potential for harmful consequences resulting from alcohol and cannabis use, it is important to understand why people use these substances. Childhood maltreatment has been identified as an important predictor of alcohol and cannabis use. However, less is known about the mechanisms underlying this relationship, though it seems emotion regulation may play an important role. This study explores the relationship between maltreatment and emotion dysregulation, in addition to the relationship between maltreatment and affective motives for using alcohol and marijuana. Results indicate that drinking to cope mediates the relationship between all measured forms of maltreatment and alcohol consequences. However, none of the motives individually significantly mediated the relationship between maltreatment and marijuana use consequences. Results, limitations, and future directions are discussed.

To explain delinquency, General Strain Theory (GST) focuses on negative relationships with others. As one type of victimization, exposure to violence is significantly related to juvenile crime and substance abuse. In addition, victimized adolescents commonly experience post-traumatic stress disorder (PTSD). However, little research has investigated the mediating role of PTSD in the association between violent victimization and juvenile delinquency. Using data from the National Survey of Adolescents (1995), the present study examines the direct effects of sexual assault, physical assault, and witnessing violence on inner- (alcohol and illicit drug use) and outer-directed behaviors (property and violent crime). This study also examines the mediating role of PTSD, based on an overall scale of PTSD as well as the individual components of PTSD (re-experiencing, avoidance/numbing, and hyperarousal). Logistic regression analyses and the Sobel test were used to examine the hypotheses. Findings in the study provide support for the proposition of GST that violent victimization increases the risk of juvenile crime and substance use. Findings also indicate that exposure to violence results in a higher probability of exhibiting PTSD symptoms. Finally, PTSD clusters partially mediate the link between violent victimization and outer-directed responses. However, the expected mediating effect between violent victimization and inner-directed responses was not found. Theoretical implications and limitations are discussed.

This study aimed to 1) replicate existing research linking childhood sexual abuse and later substance use, 2) identify intergenerational parallels between the substance use and sexual victimization experiences of adolescent girls and their mothers, and 3) evaluate early pubertal timing, depressive self-concept, and behavioral under-control as potential pathways to substance use for sexually abused girls. Data were drawn from 150 mother-daughter pairs participating in a longitudinal study of the impact of domestic violence on the lives of women and children. Structural equations modeling revealed that girls' childhood sexual abuse was associated prospectively with their later substance use. This relationship held (retrospectively) for mothers as well. Mothers' risk for sexual abuse and substance use was transmitted to their daughters. Early pubertal timing, depressive self-concept, and behavioral under-control among girls were all predicted by childhood sexual abuse. Only behavioral under-control was, in turn, related to adolescent substance use. Depressive self-concept contributed to behavioral under-control among girls. A series of hierarchical regressions revealed that these relationships persist when controls for co-occurring forms of child abuse (physical, exposure to domestic violence) are included. Implications and limitations of the study as well as directions for future research are discussed.

The process of recovery from addiction is a multifaceted process that involves the efforts of clients, professionals and the broader community. Additional challenges to recovery are present for individuals who use solvents. This study investigates how professionals, involved in the provision of services to clientele who use solvents, understand the process of healing in their collaborative work. Using a narrative methodology, semi-­‐structured interviews were conducted with professionals employed in providing recovery-based services to individuals who use volatile solvents. The stories of these professionals demonstrate how they view their clients as “just like everyone else” despite what the dominant cultural story says about their possibilities for recovery. The professionals told stories which are in extreme opposition to the story of dominant culture and involved groupings of “us” (professionals) versus “them” (others). These stories, and how they were told, are discussed in relation to hope for professionals who provide health and housing services.

The process of recovery from addiction is a multifaceted process that involves the efforts of clients, professionals and the broader community. Additional challenges to recovery are present for individuals who use solvents. This study investigates how professionals, involved in the provision of services to clientele who use solvents, understand the process of healing in their collaborative work. Using a narrative methodology, semi-­‐structured interviews were conducted with professionals employed in providing recovery-based services to individuals who use volatile solvents. The stories of these professionals demonstrate how they view their clients as “just like everyone else” despite what the dominant cultural story says about their possibilities for recovery. The professionals told stories which are in extreme opposition to the story of dominant culture and involved groupings of “us” (professionals) versus “them” (others). These stories, and how they were told, are discussed in relation to hope for professionals who provide health and housing services.

Depression, problematic behavior and substance use are becoming increasingly common in adolescence. This study highlights the role of emotional and behavioral issues in Swedish adolescents and their respective associations with the severity of abuse of alcohol and drugs. Self-report questionnaires were used from a sample of 180 individuals enrolled in a Swedish clinic for adolescent substance abuse, aged 12-20. Results showed that individuals with behavior problems had the strongest association with substance use overall. Specifically, rule breaking behavior followed by withdrawal/depression. Examining gender differences showed that girls had the strongest associations with substance use overall. Implications for future research are discussed.

Health promotion and public health research increasingly recognise that a range of community organisation and attitudinal factors are important to a community’s level of readiness, or capacity, to undertake effective prevention activity required to reduce population rates of adolescent substance abuse. Although the importance of tailoring community capacity building to readiness levels is acknowledged, little research has been done to date, to develop a systematic framework for measuring readiness in Australia. / Equally in Australia where national and state government drive public health drug policy and programme development, their interaction and support of community level interventions and efforts has not been widely examined. / This methodological study of 100 telephone interviews with 60 community practitioners (15 in each community) was conducted to identify and assess the specific attitudinal, systemic and resource characteristics of four regional communities in order to extend their capacity or readiness to address adolescent substance abuse within their community. The study provided the opportunity to assess the feasibility, reliability and validity and utility of two North American questionnaires that had been developed to provide quantitative measurement of community readiness. Additional questions were included to try and gauge to what extent state government engaged with, and responded to, the four regional communities in the planning and initiation of prevention activity. Examination of this domain would also contribute to the understanding of state and community engagement with community empowerment. / Each of the readiness questionnaires appeared comprehensible within the Australian context, requiring only minor modifications to wording and format to obtain reliable responses from community practitioners. Community readiness ratings for the four communities were consistent across the two instruments with each questionnaire assessing some overlapping and some distinct domains. / The comparison of results from the two community readiness survey instruments suggested some advantages for the TECPR instrument in its slightly higher face validity to key informants and its ability to significantly discriminate the total readiness scores for the four communities. Analysis revealed some associations between the two readiness assessment methods; supporting the view that they were assessing some common underlying dimensions but also that they each provided some unique information. Analysis of the additional questions related to community empowerment suggested that the two assessment methods each contributed unique information in predicting local perceptions of community empowerment. / It is concluded that each questionnaire has the potential to elicit detailed and reliable data concerning community-readiness, which can be quantitatively analysed; and is not unduly time-consuming or burdensome to the researcher or the respondents. One of the questionnaires holds particular merit for communities where research expertise in not available. Measurement of community readiness appears feasible in the Australian context opening opportunities for improved planning and evaluating of community development initiatives aimed at preventing adolescent substance abuse.

BACKGROUND: Substance use disorders are highly prevalent and highly stigmatized. They are defined as conditions in which the use of one or more substances, in spite of negative consequences, leads to a clinically significant impairment or distress. Stigma is a characteristic deemed undesirable by society. Stigma is dependent on the relationship between the specific discrediting or undesirable characteristic and the social context. LITERATURE REVIEW FINDINGS: The various manifestations of stigma include public or external stigma, provider stigma, and internal stigma. External stigma is the negative beliefs that society holds about people in stigmatized groups, for example patients with substance use disorders or HIV. Another type of stigma is provider stigma, referring to the negative beliefs that providers hold about patients belonging to these stigmatized groups. Internal stigma is defined as the devaluation that people in stigmatized groups hold about themselves in relation to society. Stigma is continued when there is a lack of familiarity and education with a stigmatized condition or group. PROPOSED PROJECT: The proposed project aims to address and decrease provider stigma in physician assistant trainees before they begin their clinical training through an educational intervention. This thesis will propose the development and evaluation of a new curriculum to educate physician assistant students on substance use disorders and their treatments, frame substance use disorders as chronic diseases, and aid physician assistant student trainees on recognizing their attitudes and biases, or prejudices, toward working with patients with substance use disorders. The project will assess attitudes before and after the education intervention to analyze if attitudes toward patients with substance use disorders have changed as a result of the educational intervention. The goal of the educational curriculum is to improve physician assistant student attitudes toward working with patients with substance use disorders before they encounter this population in clinical practice. SIGNIFICANCE: Physician assistants are clinicians who diagnose illness, develop treatment plans, manage their own patients, and often serve as the primary clinician for patients. Physician assistants will encounter a number of patients with substance use disorders throughout the course of their careers. Addressing provider stigma in this group will help improve treatment outcomes in this patient population and give the students the confidence and knowledge to manage patients with substance use disorders. As a result of completing this curriculum, physician assistant students will have decreased stigma and better attitudes toward working with patients with substance use disorders.

Magister Artium (Child and Family Studies) - MA(CFS) / Substance use amongst youth in Grabouw has been recognised as a concern by the community. Essentially parenting styles and family functioning are important contributors to adolescents‘ engagement in substance use. Adolescence is a sensitive time for youths as they are faced with many developmental changes; consequently it is vital for positive parenting styles and healthy family functioning to be present to ensure healthy development. However, previous research shows that families of substance users do not function in a healthy manner and tend to have negative parenting styles. The aim of this study is to compare family functioning and parenting styles within the families of substance users and non-users in Grabouw. The study used a quantitative approach with a cross-sectional, correlational comparative design. The sample consisted of 300 adolescents between the ages of 15-17 years in schools in Grabouw. The participants completed the McMaster Family Assessment Device (FAD) and the Parenting Styles Dimension Questionnaire (PSDQ). Descriptive statistics and the Pearson correlation were used to analyse the data. A t-test was used to determine the differences between groups. The findings of the study show that there is no difference in family functioning between the user and non-user groups. Notably, findings reveal that authoritative and permissive parenting styles are the prevalent parenting styles in both user and non-user groups. Furthermore the results indicate that the authoritarian parenting style was higher in the substance using group. The findings also show that there is no correlation between family functioning and the authoritative parenting style.